Bariatric Surgery and Pregnancy Nutrition: What You Need to Know
Bariatric surgery, or weight loss surgery, has become an increasingly common intervention for individuals seeking to manage excess body fat and improve fertility outcomes. While it can support metabolic health and increase chances of conception, there are important nutritional risks, especially during pregnancy, that need to be carefully managed.
So, let’s explore how bariatric surgery can affect pregnancy nutrition, and how to support a healthy pregnancy after surgery.
What Is Bariatric Surgery?
Bariatric surgery includes a range of surgical procedures that reduce the size of the stomach and/or alter the digestive tract to promote weight loss. Common types of weight loss surgery methods include the gastric sleeve, the gastric bypass, and adjustable gastric banding.
These surgeries are especially popular among females of reproductive age who have struggled with losing body fat for years despite best efforts through diet and exercise.
Why? Reducing excess body fat can improve fertility outcomes by reinstating ovulation and reduce pregnancy complications related to higher body weight, such as gestational diabetes and hypertension in pregnancy.
However, when it comes to pregnancy nutrition, bariatric surgery introduces a unique set of challenges.
Why Nutrition Matters Post-Surgery in Pregnancy?
Pregnancy increases your body’s nutritional demands and if you’ve had bariatric surgery, your ability to absorb essential nutrients may be compromised, depending on the type of surgery you had.
Some surgeries are malabsorptive, meaning they reduce nutrient absorption in the gut. Others are restrictive, limiting how much food you can eat.
Either way, both approaches can lead to deficiencies in critical vitamins and minerals needed to support a healthy pregnancy.
The Research on Bariatric Surgery and Pregnancy Nutrition
A recent narrative review published in 2023 investigated the impact of different bariatric surgery techniques on micronutrient status during pregnancy and how this may affect maternal and foetal health. This review summarised findings from multiple studies, providing a comprehensive overview of risks and recommendations
Some of the key findings from the review included:
- Bariatric surgery is increasingly common among women of childbearing age.
- Nutritional deficiencies post-surgery can result from reduced intake and malabsorption, both of which may increase the risk of maternal and foetal complications.
- Malabsorptive techniques (e.g., gastric bypass) were associated with a higher risk of complications, including maternal anaemia and low-birth-weight babies.
- There was an observed increase in risks such as preterm delivery, small-for-gestational-age (SGA) infants, perinatal mortality, and neonatal intensive care unit (NICU) admissions.
This study underscores the importance of nutritional monitoring and intervention for women who have undergone bariatric surgery and are planning a pregnancy.
Key Micronutrient Deficiencies After Bariatric Surgery
Several nutrients are at higher risk of deficiency post-surgery, many of which are essential for foetal development:
- Folate: Usually easy to manage with a quality prenatal multivitamin.
- Vitamin B12: Rare, but possible in those with poor dietary intake or absorption issues.
- Thiamine (B1): At higher risk due to low body stores, as its a water-soluble vitamin, a B1 deficiency can occur quickly with inadequate intake.
- Calcium & Vitamin D: Increased risk of vitamin D deficiency. Bariatric surgery can induce calcium deficiency due to low dietary intake and malabsorption.
- Vitamin A: Bariatric surgery is nowadays one of the leading causes of clinical vitamin A deficiency in developed countries.
- Iron: The risk of iron deficiency anaemia increases, especially as time after surgery progresses.
- Zinc
- Magnesium
- Selenium
- Copper
- Iodine: especially important to support maternal thyroid health and also support your future baby’s cognitive and intellectual development.
Note: The type of surgery you’ve had will influence which nutrients are at-risk for you. The best person to discuss this with is your surgeon and dietitian.
Potential Impacts of Bariatric Surgery on Pregnancy Outcomes
Research shows pregnant women with a history of bariatric surgery may experience:
- Increased risk of low birth weight and small-for-gestational-age (SGA) babies
- Higher rates of pre-term birth
- Increased chance of caesarean delivery
- Higher risk of perinatal mortality and NICU admission
- Reduced risk of having a high birth weight baby
In general, malabsorptive techniques are associated with a higher risk of complications in pregnancy after bariatric surgery, especially maternal anaemia and low-birth-weight babies.
How to Support a Healthy Pregnancy After Bariatric Surgery
If you’ve had bariatric surgery and are planning a pregnancy, here’s what you need to do:
- Address micronutrient deficiencies before conception.
- Work with a fertility dietitian to develop a personalised prenatal nutrition and supplement plan based on your surgery type and recent blood work.
- Choose supplements carefully – standard prenatal vitamins may not be enough.
- Monitor nutrient levels regularly throughout pregnancy.
- Eat a nutrient-rich, balanced diet designed to optimise absorption and support your growing baby.
Bariatric surgery can be a transformative tool for improving fertility and metabolic health, but it also comes with significant nutritional considerations, especially during pregnancy.
Whether you’re trying to conceive or are already pregnant after bariatric surgery, working with a qualified fertility dietitian can help you feel confident and supported in making informed, science-backed choices.
Ready to Feel Confident About Pregnancy Nutrition After Bariatric Surgery?
Book in for our most popular 2-hour Fertility Nutrition Intensive, a personalised, online consultation with one of our expert fertility dietitians. We’ll create a tailored nutrition and supplement plan that supports your unique post-surgery needs, helps correct deficiencies, and sets you up for a healthy pregnancy.
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